Surgery Versus Thrombolytic Therapy for the Management of Left‐Sided Prosthetic Valve Thrombosis Without Hemodynamic Compromise: A Systematic Review and Meta‐Analysis

Figures

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  Figure 1. Pooled risk difference (and associated exact CI) for death between systemic thrombolysis and cardiac surgery for the management of left‐sided prosthetic valve thrombosis.

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  Figure 2. Pooled risk difference (and associated exact CI) for magnetic resonance imaging–defined stroke (A) and non‐CNS embolism (B) between systemic thrombolysis and cardiac surgery for the management of left‐sided prosthetic valve thrombosis. CNS indicates central nervous system.

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  Figure 3. Sensitivity analyses of studies that used a low‐dose or slow‐infusion thrombolytic strategy (with regard to the standard dosing of systemic thrombolytic as reference; https://www.fda.gov/drugs). 20 , 28 , 34 CNS indicates central nervous system; and TIA, transient ischemic attack. *No events reported for TIA.

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  Figure 4. Meta‐regression analysis on the transformed proportion using mixed effects to describe the relationship between prognostically relevant covariates (ie, mitral valve thrombosis [%] [A], acute heart failure [%] [B]), and the logit odds ratio of death.

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  Figure 5. Funnel plot and corresponding Egger's regression asymmetry test to assess publication bias in mortality outcome for comparison between systemic thrombolysis and cardiac surgery for the management of left‐sided prosthetic valve thrombosis.